Organization
WALGREEN EASTERN CO, INC
Active
Parent organization
WALGREENS BOOTS ALLIANCE INC
Other names
WALGREENS #05723
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALGREENS BOOTS ALLIANCE INC
Authorized official
KIRA L TAYLOR (MANAGER)
(217) 709-2351
Entity
Organization
Contact information
Practice address
960 NORTH AVE, BRIDGEPORT, CT 06606-5750
(203) 334-6978
Mailing address
1901 E VOORHEES ST, MS #790, DANVILLE, IL 61834-4509
(217) 709-2351
(217) 709-2344
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
1418
CT
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004114055
—
CT
05
—
004121000 DME
—
CT
01
—
0714039
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/29/2006
Last updated
04/28/2022
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